Short term fix won’t work for NHS

Twitter buzzed with news that the NHS outpaced the UK economy in productivity gains early last week, reports the productivitypuzzle.com website.

The announcement came from Professor Andrew Street and Research Fellow Katja Grasic, both of the Centre for Health Economics, University of York.

The party came to an abrupt end with the damning report from Lord Carter, published last Friday, laying bare the NHS’s productivity problems, and making 15 recommendations that could release efficiency savings of up to £5 billion a year.

Lord Carter’s review echoes what Unipart Group chairman John Neill told the Guardian just a few weeks ago, when he called for “a complete overhaul rather than the current ‘patchwork quilt’ approach.” He went on to explain, “You could get the quality up, you could get the cost down, you could improve the culture of engagement, and you could create time for innovation.”

Street and Grasic did question the sustainability of the NHS’s productivity gains, putting it down to restricting staff levels and working harder. They even wrote, “Looking forward, it will not be enough simply to work existing inputs harder. Rather the NHS will have to become better at reducing inefficiencies and unwarranted variations in practice.”

Examining 137 out of 156 acute hospitals trusts, Lord Carter’s report outlines the inefficiencies and variations in practice. One stark variation: average running costs for an entire hospital (£m/2), starts at £105 at one trust, and skyrockets to £970 for another.

The Royal College of Nursing fought back that Carter’s initiatives could, “endanger patient safety.” The Guardian added, “Chris Hopson, chief executive of NHS Providers, which represents hospitals, said trust bosses would be “nervous” about having targets foisted on them, such as running costs being no more than 7% of their income.”

Last month, the Guardian, sounding like Unipart’s John Neill, wrote, “All too often the focus has been on the one-off, short term and tactical. There has been little drive to address the fundamental barriers to a more efficient and productive service.”

Therein lies the challenge.

A cultural shift must happen. Ivory towers need to be abolished and silos waylaid.Neill has stressed before that it’s not about blame, but identifying smarter ways of working and caring for patients.

If anyone thinks Lord Carter’s review is an attack, think again. The report states that “the NHS ranks as the best value healthcare system in the world.” Because of that, it deserves to be fixed.

Using its culture of continual improvement, which they call ‘The Unipart Way’, Unipart Group has helped Trusts around the country save millions while improving patient care. So yes, it can be done. Lord Carter’s findings are not asking the impossible.

Just ask the Trusts who got on board by implementing The Unipart Way. With cultural shift comes employee engagement. Try asking the ones who care for the patients where they can do better. They probably know. Ask senior management. Talk to the scheduling teams and theatre staff.

Lord Carter’s review identifies the need to share information with the frontline. This is crucial. Transparency is a part of employee engagement. It puts everyone on the same page.

Jeremy Hunt, Secretary of State for Health – the man who requested the review – called Lord Carter’s recommendations “far-reaching opportunities for improving productivity and efficiency across the NHS.”

Opportunities are exciting. If the NHS takes advantage of them and turns the beloved British institute around, this could be their finest hour. Sceptics will say this is simplifying complicated issues.

That is the goal.

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